Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | MD02179 | NJ |
NPI | 1083756431 |
---|---|
Provider Name | Dr. Darren Jerry James |
First Address | Hazlet, NJ 07730-4004 |
Second Address | Hazlet, NJ 07730-4004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 08/07/2007 |